代谢风险所致缺血性心脏病的全球、区域和国家负担：《2021年全球疾病负担》的系统分析
Global, regional, and national burden of ischemic heart disease attributable to metabolic risks: a systematic analysis of Global Burden of Disease 2021.
作者信息
Liu Bo-Qing, Yang Chang, Wei Heng-Yang, Yu Zai-Xin
机构信息
Department of Clinical Medicine, Xiangya Medical School, Central South University, Changsha, China.
Department of Cardiology and National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University, Changsha, China.
出版信息
J Geriatr Cardiol. 2025 Mar 28;22(3):361-380. doi: 10.26599/1671-5411.2025.03.009.
BACKGROUND
Ischemic heart disease (IHD) represents the most significant disease burden among all cardiovascular diseases (CVDs). The increasing prevalence of metabolic risks in the 21 century has a profound impact on the disease burden associated with IHD. We analyzed the global, regional, and national burdens of IHD attributable to metabolic risks from 1990 to 2021.
METHODS
The data were taken from Global Burden of Disease (GBD) study 2021. Deaths, disability-adjusted life years (DALYs), the average annual percent change (AAPC), age-standardized death rates per 100,000 persons (ASDR) and age-standardized rate per 100,000 persons (ASR) of DALYs ranging from 1990 to 2021, were extracted and stratified according to region, nationality, socio-demographic index (SDI), sex, and age. Additionally, the global future trends were predicted using Nordpred prediction model.
RESULTS
Compared to 1990, in 2021, the number of death and DALYs from metabolic risk-attributed IHD increased globally by 67.35% and 59.91%, respectively; whereas ASDR and ASR of DALYs showed a decreasing trend and the most severe impact was observed in male and elderly populations. In addition, the burden of disease showed an inverted V-shaped relationship with SDI from 1990 to 2021. AAPC showed a significant increase in developing countries and a decrease in developed countries. We also analyzed the effects of different risk factors including metabolic risk factors on IHD in different SDI regions and genders. The prediction of future disease burden showed that the number of death and DALYs will keep rising, while ASDR and ASR of DALYs will maintain a certain downward trend.
CONCLUSIONS
The results of this study highlighted the need for screening and intervention for metabolic risk factors in specific regions and populations, this should call for increased collaboration between developing and developed countries to reduce the burden of disease and improve the prognosis of patients with IHD.
背景
缺血性心脏病（IHD）是所有心血管疾病（CVD）中疾病负担最重的。21世纪代谢风险患病率的上升对与IHD相关的疾病负担产生了深远影响。我们分析了1990年至2021年全球、区域和国家层面归因于代谢风险的IHD负担。
方法
数据取自《2021年全球疾病负担（GBD）研究》。提取了1990年至2021年的死亡人数、伤残调整生命年（DALY）、年均变化百分比（AAPC）、每10万人的年龄标准化死亡率（ASDR）以及每10万人的DALY年龄标准化率（ASR），并按地区、国籍、社会人口指数（SDI）、性别和年龄进行分层。此外，使用Nordpred预测模型预测了全球未来趋势。
结果
与1990年相比，2021年全球归因于代谢风险的IHD死亡人数和DALY分别增加了67.35%和59.91%；而DALY的ASDR和ASR呈下降趋势，男性和老年人群受影响最为严重。此外，1990年至2021年疾病负担与SDI呈倒V形关系。发展中国家的AAPC显著上升，发达国家则下降。我们还分析了不同风险因素（包括代谢风险因素）对不同SDI地区和性别的IHD的影响。未来疾病负担预测显示，死亡人数和DALY将持续上升，而DALY的ASDR和ASR将保持一定的下降趋势。
结论
本研究结果凸显了在特定地区和人群中对代谢风险因素进行筛查和干预的必要性，这需要发展中国家和发达国家加强合作，以减轻疾病负担并改善IHD患者的预后。
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